The Mental and physical health deterioration caused by missed doctor's appointments during the covid-10 pandemic
During a massive portion of 2020, especially during the beginning of the pandemic, many businesses closed down temporarily due to COVID-19 restrictions. Those that were able to stay open, the essential businesses and certain doctor’s offices and such, had to attempt to navigate this bizarre new world. For some offices, they begun care at an emergency only basis. People that had appointments were canceled. Even as restrictions somewhat loosened and appointments were able to be rescheduled, many people felt uncomfortable to do so, due to the coronavirus and the valid fears that surround it.
A new report titled “Delayed and Forgone Health Care for Non-elderly Adults during the COVID-19 Pandemic,” has been recently published on the Urban Institute’s website on February 16th, 2021. They used data from over 4000 adults aged 18 to 64, collected by their own September 2020 Coronavirus Tracking Survey. While reviewing the data compiled by the survey, researchers noticed around one-third, or 36% of non-elderly adults delayed health care or did not get care because they were either concerned about being exposed to the coronavirus, or because their health care provider was offering limited services due to the pandemic.
Among those who did delay or completely miss a health care appointment, 32.6% revealed that the gap in care caused one or more of their health conditions to deteriorate, or restrict their ability to be productive at work or other daily chores and activities. Researchers note the findings exemplify “the detrimental ripple effects of delaying or forgoing care on overall health, functioning, and well-being.”
The Urban Institute examined the data encompassing delayed or forgone care during the pandemic for nine different types of health care services and analyzed patterns by race/ethnicity, income and the presence of pre-existing physical and mental health conditions. The nine different areas of health care questioned in the survey concern delays in prescription drugs, general doctor and specialist visits, going to a hospital, preventive health screenings or medical tests, treatment or follow-up care, dental care, mental health care or counseling, treatment of counseling for alcohol or drug use, and other types of medical care.
They noticed that individuals with one or more chronic health problems are more likely to have delayed or forgone care. The numerical difference being 40.7% versus 26.4%. Those with a mental health condition were particularly susceptible. Dental care was the most common delayed area of health care among respondents at 25.3%, followed by general doctor or specialist visits at 20.6% while preventive health screenings or medical tests stand third in line, at 15.5%.
African American adults were more likely than White or Hispanic/Latino adults to report having delayed or forgone care at 39.7%, with White adults at 34.3%, and Hispanic/Latino adults at 35.5%. Also, low income individuals were of higher likelihood to have forgone multiple types of care at 26.6%, when compared to their high income counterparts at 20.3%.
Some doctors are already noticing the repercussions of these missed visits. Dr. Jacqueline W. Fincher, president of the American College of Physicians tells Medscape about two patients of hers that missed appointments during 2020. Both patients have long-term health issues. When they each began care again in 2021, their laboratory tests revealed noticeable kidney deterioration. Fincher, who works as a general internal medicine physician in Georgia, shares that one of the patients “was in the hospital for three days and the other one was in for five days.”
According to Fincher, her office in particular vows to have been take charge when it comes to reminding patients with chronic diseases who have missed follow-up appointments or have laboratory tests to reschedule. She states they are also proactive as far as calling patients who may have run out of medication. Dr. Fincher states that the majority of delays have been at the fault of the patient postponing appointments. Her office has been open during the entirety of the pandemic, and provides telehealth appointments, as well as in-person visits that follow the CDC’s suggested safety precautions.
One article published online on Frontiers in Psychology during September of 2020, similarly talks about the “devastating ripple effects of the COVID-19 crisis.” Written by Michaéla C. Schippers, she believes it to be “expected that hundreds of millions of people will die from hunger and postponed medical treatments.” However, there is no current data backing the numerical validity of her prediction, but there is research that seems to support her claims surrounding the possible negative effects the lockdown may have on an individual’s mental health, along with the dangers surrounding delayed health care.
Schippers believes many of the negative psychological effects crafted by the COVID-19 virus can be counteracted “by means of online life crafting therapeutic writing interventions,” and various other coping methods. She explains that life crafting expressive writing can generate positive emotions, be very self motivating, and ascribe new meaning to one’s life. It is the practice of writing about one’s ideal life and goals, including plans to achieve these goals. Schippers cites various sources to support her theory that these sorts of writing exercises may be productive in improving well-being. Some of the other positive coping strategies she mentions is healthy eating and exercise, as well as social support.
She ends her article with several suggestions, one of which advocates for the government to provide the public with more information about effective coping methods. Schippers also states that her hope is that “the negative side effects will, to some extent, be counteracted via smart interventions and community care.”
As many are aware, chronic problems that are left on their own, whether they be mental or physical, can often result in internal damage. Many of the issues that have come from delayed and foregone appointments due to the COVID-19 pandemic have not been studied yet. As experts uncover and analyze further data surrounding patient outcomes, a better picture of these negative repercussions can be formed. Regardless, this teaches not to ignore or postpone healthcare appointments, whether they are physical or mental, all are important. Medical facilities have many procedures in place currently designed to protect themselves and the general public from further transmitting coronavirus, and if possible in one’s current situation, telehealth care services are highly recommended.